If you think the desire for
straight teeth is a trapping of modern society, think again!
Extreme Makeovers may be new, but "braces" date as far back as
ancient man!

Early History

Even ancient people wanted
straight teeth! According to the AAO (American Association of
Orthodontists), archaeologists have discovered mummified
ancients with crude metal bands wrapped around individual teeth.
To close gaps, it has been surmised that catgut did the work
now
done by today's orthodontic wire! Later, in 400-500 BC,
Hippocrates and Aristotle both ruminated about ways to
straighten teeth and fix various dental conditions. Straight
teeth have been on our minds a very long time!

While Greece was in its Golden
Age, the Etruscans (the precursors of the Romans) were burying
their dead with appliances that were used to maintain space and
prevent collapse of the dentition during life. Then in a Roman
tomb in Egypt, a researcher found a number of teeth bound with a
gold wire -- the first documented ligature wire! At the time of
Christ, Aurelius Cornelius Celsus first recorded the treatment
of teeth by finger pressure. Despite all this evidence and
experimentation, no significant events in orthodontics really
occurred until the much later, in around the 1700s (although
dentistry as a whole made great advancements in the interim). It
should be noted that in Medieval times, specialized barbers
often performed dental "operations", extractions, and procedures
such as blood-letting. Let's be glad we live in the 21st
Century!

Important Breakthroughs

Even before George Washington
wore his famous wooden teeth, dentists were thinking about ways
to correct bad bites. In 1728, French Dentist Pierre Fauchard published a book
called the "The Surgeon Dentist" with an entire chapter on ways
to straighten teeth. Fauchard used a device called a "Bandeau,"
a horseshoe-shaped piece of precious metal which helped expand
the arch. French Dentist Ettienne Bourdet followed
Fauchard in 1757 with his book "The Dentist's Art", also
devoting a chapter to tooth alignment and appliances. Bourdet
was the dentist to the King of France. He further perfected the
Bandeau, and is also the first dentist (on record) who
recommended extraction of premolars to alleviate crowding. He
was also the first to scientifically prove jaw growth. Here's a
link to a series of pages with some fascinating
illustrations of early expansion devices.

Scottish
surgeon John Hunter wrote (among other surgical books) "The
Natural History of the Human Teeth" in 1771, clearly describing
dental anatomy. Hunter coined the terms bicuspids,
cuspids, incisors and molars. His second
book, "A Practical Treatise on the Diseases of Teeth", described
dental pathology. Although teeth straightening and extraction
to improve alignment of remaining teeth has been practiced since
early times, orthodontics as a science of its own did not really
exist until the mid-1800s.

In 1819 Delabarre introduced
the wire crib, which marked the birth of contemporary
orthodontics. The term orthodontia was coined by Joachim Lafoulon
in 1841. Gum elastics were first employed by Maynard in 1843.
Tucker was the first to cut rubber bands from rubber
tubing in 1850. And in the late 1800s, Eugene Solomon Talbot was the
first person to use X-rays for orthodontic diagnosis. But all
this was nothing compared to advances in orthodontics
in the 20th Century.

Daddy-O (as in Orthodontic)

Historians claim that several men deserve the title of being called "The Father of
Orthodontics." Fauchard certainly took orthodontics out of
the dark ages, but these men really put maloclussion on the map. One man was Norman W. Kingsley, a dentist,
writer, artist, and sculptor. In 1858, he wrote the first
article on orthodontics, and in 1880, his book "Treatise on Oral
Deformities" was published. The second man who deserves credit
was a dentist named J. N. Farrar who wrote two volumes entitled
"A Treatise on the Irregularities of the Teeth and Their
Corrections". Farrar was very good at designing brace
appliances, and he was the first to suggest the use of mild
force at timed intervals to move teeth.

In
America in the early 1900s, Edward H. Angle devised the first
simple classification system for malocclusions, which is still
used today (Class I, Class II, and so on). His classification system was a way for dentists to
describe how crooked teeth are, what way teeth are pointing, and
how teeth fit together. Angle contributed significantly to the
design of orthodontic appliances, incorporating many
simplifications. He founded the first school and college of
orthodontics, organized the American Society of Orthodontia in
1901 (which became the AAO in the 1930s), and founded the first
orthodontic journal in 1907. A journal and website bearing his
name still thrive today. His highly praised reference book,
"Malocclusion of the Teeth" went through seven editions. In the
wake of all these advancements, the field of orthodontics and dentofacial
orthopedics eventually became a respected dental specialty in
its own right.

Other innovations in
orthodontics in the late 1800s and early 1900s included the
first textbook on orthodontics for students, published by J.J.
Guilford in 1889, and the use of rubber elastics, pioneered by
Calvin S. Case (some believe it was H. A. Baker).

The First Metal Mouths

What
did braces look like a century ago? In the early 1900s,
orthodontists used gold, platinum, silver, steel, gum rubber,
vulcanite (and occasionally, wood, ivory, zinc, copper, and
brass) to form loops, hooks, spurs, and ligatures.
Fourteen- to 18-karat gold was routinely used for wires, bands,
clasps, ligatures, and spurs, as were iridium-platinum bands and
arch wires, and platinized gold for brackets. Why gold? It is
malleable and easy to shape. Gold had its drawbacks, however -- because of its softness it
required frequent adjustments, and it was expensive! Anyway, you guessed it -- these
bands wrapped entirely around the each tooth -- the original
"metal mouth" was real gold or silver! How's that for
bling?

In 1929, the first dental
specialty board, the American Board of Orthodontics, was born.
On a side note, the first synthetic (nylon)-bristle toothbrush
was invented in 1938. Around this time, stainless steel became
widely available, but using it for braces was considered somewhat
controversial. It wasn't generally accepted as a material for
orthodontic treatment until the late 1950s/early 1960s! In addition, you may
be surprised to learn that x-rays were not routinely used in
orthodontic treatment until the 1950s!

Advancements in the 1970s

Braces continued to wrap around
the teeth until the mid 1970s, when direct bonding became a
reality. Why did it take so long for dentists to invent the
modern bonded bracket? The adhesive! The bonded bracket was
actually invented earlier, but the formulation for the adhesive
wasn't perfected until almost a decade later. At first, bonded
brackets were (of course) made of metal. Like any new method, it
took a while for the direct bond bracket to catch on -- which is
why some people may remember wearing the old "wrap around" metal
braces into the late 1970s.

Around this time, the self-ligating
bracket also appeared on the scene.
Self-ligating brackets don't
need tie wires or elastic ligatures to hold the arch wire onto the
bracket -- they are held on by a "trap door" built into each bracket. As
early as 1935, the idea of a self-ligating brackets began to
take shape. Over the years many designs were patented, but few
were commercially available until Ormco created the Edgelock
system in 1972. As the 1980s and 1990s progressed, many companies
created their own versions of self-ligating brackets and
improved upon the idea by offering both passive and active
resistance on the arch wire. Nowadays, we have a number of self-ligating choices,
such as Orec's Speed Braces, Ormco's Damon System, GAC's
In-Ovation, and Adenta's Evolution.

In the 1970s, Earl Bergersen,
DDS created the passive Ortho-Tain appliances, which guide jaw
growth and help correct orthodontic problems and malocclusions in both children
and adults. The Ortho-Tain appliances look like custom plastic
mouthguards, and are worn mainly at night,
or for only a few hours each day. In many cases, people have
been able to correct (or greatly diminish) many types of
orthodontic problems with these removable custom-made
appliances.

Around 1975, two orthodontists
working independently in
Japan and the United States started
developing their own systems to place braces on the inside
surfaces of the teeth -- lingual braces. These "invisible
braces" offered people the results of bonded brackets with one
big advantage -- they were on the inside of the teeth, so nobody
else could see them! In America, the late Dr. Craven Kurz of Beverly Hills California developed the Kurz/Ormco
lingual system. In Japan, Professor Kinya Fujita, of Kanagawa
Dental University invented his own lingual system, and continues
to make great advances in the lingual method.

It takes special training to
treat a patient with lingual braces, and many American orthodontists in the 1970s and 1980s were reluctant to use the
method -- but orthodontists in other countries readily embraced
it, and continued to make advancements with new techniques.
Recently, lingual braces have become more popular because
technology has made them more comfortable. One example is iBraces,
a company which custom-fabricates brackets for a patient's teeth with the aid of digital computer imaging.

Lingual braces were the
"invisible" braces of choice until the early 1980s, when "tooth
colored" esthetic brackets made from single-crystal sapphire and
ceramics came into vogue. Nowadays we also have brackets made
from a combination of ceramic and metal -- giving the patient a
strength of metal with esthetic look of less noticeable "tooth
colored" braces. Recently, a European company even invented
a ceramic bracket that is self-ligating!

Invisible Braces via Silicon Valley

As far back
as 1945, orthodontists realized that a sequence of removable
plastic appliances could move teeth toward a predetermined
result. Some orthodontists even made simple plastic "aligner
trays" in their offices for minor adjustments.

But it took an adult who'd just had braces to take the concept a
step further.

Invisalign was the brainchild
of Zia Chishti and Kelsey Wirth, graduate students in Stanford
University's MBA program. Wirth had traditional braces in
high school (she reportedly hated them). Chishti had finished adult treatment with
traditional braces and now wore a clear plastic retainer. He
noticed that if he didn't wear his retainer for a few days, his
teeth shifted slightly -- but the plastic retainer soon moved
his teeth back the desired position. In 1997, he and Wirth
applied 3-D computer imaging graphics to the field of
orthodontics and created Align Technologies and the Invisalign
method. With a boost from
ample Silicon Valley venture funding, Align soon took the
orthodontic industry by storm. Dentists and other dental
companies were skeptical at first, because neither Chishti nor
Wirth had any professional dental training. Invisalign braces were first made
available to the public in May, 2000 and proved extremely
popular with patients. Soon similar products began appearing on
the market, made by GAC,
3-M Unitek, Ormco, OrthoClear, and
others.

The Future: Technology Continues to
Advance

As technology enhances our
daily lives, it also continues to advance the science of
orthodontics. More and more
companies are utilizing digital
computer imaging to make orthodontic treatment more precise. The SureSmile system by OraMetrix, for example, takes a detailed 3-D
model of a patientís teeth and helps the orthodontist develop a
precise treatment plan for tooth movement. The orthodontist's
treatment plan then drives a highly accurate robotic process to
customize the arch wires needed for treatment. This often
shortens treatment time and gives highly accurate results.

NASA developed one of the late
20th century's most dramatic orthodontic breakthroughs:
heat-activated nickel-titanium alloy wires. At room temperature,
heat-activated nickel-titanium arch wires are very flexible. As
they warm to body temperature they become active and gradually
move the teeth in the anticipated direction. Because of their
high-tech properties, these wires retain their tooth-moving
abilities longer than ordinary metal wires and need less
frequent attention from the orthodontist. Many orthodontists now
employ heat-activated wires in their treatment plans.

What does all this mean for the
orthodontic patient of the future? As companies develop more
precise, high-tech materials and methods, your braces will be on
for a shorter period of time, be smaller and less visible,
result in less discomfort, and give great results. We've sure come a
long way from the wrap-around "metal mouth" -- and that's
something we can all smile about!

The following references and
websites provided information, images, (and in some cases, whole
sentences) for this article. Thanks to: